In Pictures: How 19 Tech Titans Target Healthcare

Healthcare is a huge market with much room for improvement. Here's how the world's largest technology companies -- from Amazon to Verizon -- are lining up for a piece of the pie.

Healthcare accounts for about 10 percent of global GDP, according to the World Bank.
In the United States, where spending hit $2.8 trillion in 2013, it's almost twice that. In the last 12 years, healthcare has almost single-handedly driven American job growth and now accounts for 13 percent of the U.S. workforce.
But healthcare remains an IT laggard. At many facilities, fax machines reign supreme. Doctors carry pagers. Patients receive appointment reminders via snail mail. What electronic data does exist frequently gets lost or stolen. It's no surprise, then, that the world's largest IT firms clamor to bring 21st century analytics, mobility, collaboration, security and services to healthcare.

Key Issues: Compliance, Interoperability and Usability
Healthcare isn't like most verticals. HIPAA and FDA regulations complicate any process that involves viewing, sharing and storing patient data. Moreover, that data typically sits in silos, since EHR systems and other clinical applications aren't designed to share information. On top of that, those apps — many designed more than a decade ago with the sole purpose of mimicking the paper patient chart — don't align with today's clinical workflows and actually make the care process less efficient, increasingly complicated and more error-prone.
Clearly, the following 19 firms (presented in alphabetical order) have their work cut out for them. Then again, they do know a thing or two about disruption.

Amazon: HIPAA-Compliant Cloud Storage
Healthcare providers struggle with storage, as most patient records, under law, must be kept for several years — some for as long as 25 years. This obviously strains data centers. Ordinarily, the cloud would be the clear alternative, but, under HIPAA, any entity possessing protected health information (PHI) must sign a business associate agreement that, among other things, makes them liable in the event of a data breach. Until recently, cloud providers were reluctant to take this risk; however, Amazon Web Services begin signing BAAs in June 2013, and other providers have since followed suit.

Apple: Rumored Health-Tracking iWatch, Earbuds
Apple is notoriously quiet, but recent rumblings suggest two things: It is developing its rumored iWatch and, along with it, an iWatch- and iPhone-compatible app referred to as Healthbook. Apple's hiring medical sensor and other medical device experts, which suggests a focus on health tracking — namely, diet, exercise, sleep, stress management and blood flow (all measured with sensors), as well as potential metrics for expectant mothers. Critically, Apple plans to display data but not interpret or manipulate it, which likely means the iWatch won't be regulated by the FDA. Also rumored: Health-monitoring earbuds. Release dates are TBD — but remember, CEO Tim Cook says Apple has big plans for 2014.

Cisco Systems: Connected Health
Not surprisingly for the company touting the Internet of Things, Cisco Systems focuses on connected health, whether through medical device management, collaboration or clinical workflow tools. Recognizing the challenges associated with EHR systems, Cisco developed its Medical-Grade Network framework to better incorporate data capture, access and storage from a host of devices — and the requisite privacy and security considerations — into the electronic health record. Since the company also knows a thing or two about unified communications, Cisco has specialized wireless, UC and switching services, which can come in handy in buildings where radiology equipment and foot-thick walls of paper records interrupt wireless signals.

Citrix Systems: Meeting Mobility Needs
Not surprising, Citrix emphasizes mobility in healthcare and all that's required to enable it, from virtualization and cloud networking to collaboration and data sharing. This is a good place to be: While healthcare typically lags in technology adoption, mobile health demand remains high thanks to its transformative potential, ease of use and fluid integration into clinical workflows (especially when compared to a desktop computer). Citrix also plays an increasing role in telemedicine, with facilities such as Miami Children's Hospital building telehealth centers to reach patients in rural areas (and expand their businesses).

Dell: Better Business Process Management
Like many others IT companies that sell hardware, software and services, Dell takes a multifaceted approach to healthcare, with tools for hospitals, physician practices, payers and life sciences firms and an overarching focus on security, the cloud and analytics. If there's a central theme, it's making data more readily available — through connected systems, the destruction of data silos and the like — in order to improve business process management on both the clinical and financial side of the aisle. Dell also positions its ultrabooks as healthcare-ready.

EMC: Back-end Building Blocks
EMC Healthcare focuses on what you may deem the less glamorous (but necessary) sides of health IT: backup, recovery, storage and records management. EMC also offers virtualized desktop environments for accessing that data, as well as research tools for analyzing that data. (This includes the recently acquired and newly named Pivotal platform.) In addition, the company can provide a cloud-based infrastructure to bring together an organization's disparate information — think EHRs, imaging and other unstructured data sources — and specialized knowledge management and clinical trial documentation systems for life sciences firms.

Facebook: Share Your Organ Donor Status
Two years ago, the world's largest social media network launched an initiative asking Facebook users to share their organ donor status. The rationale is twofold: Declaring your organ donor status will motivate others to do the same (more so than waiting in line at the DMV does) and, according to The New York Times, "could provide the evidence of consent" if someone hasn't officially registered as an organ donor. (The Facebook registry is not official.)
The social network often comes up in healthcare usability discussions, too — namely, "Why can't [application X] behave like Facebook?" To that end, the IngagePatient service uses Facebook (and 256-bit encrypted servers) as a gateway to a practice's patient portal.

GE: Innovation to Achieve the 'Triple Aim'
GE Healthcare is known primarily for imaging equipment and (notably among the tech firms on this list) Centricity, which ranks among the most widely used ambulatory EHR systems. Healthcare also plays a pivotal part in GE's focus on the Industrial Internet, which looks to improve efficiency through supply chain, inventory, hospital bed and personnel management. The company's healthymagination initiative, meanwhile, intends to bring innovation to both physician-and patient-facing systems (especially in underdeveloped areas and in research, where tech is often prohibitively expensive) to achieve the Triple Aim of improving the patient care experience and overall population health while reducing healthcare costs.

Google: Owning Health Like It Owns the Internet
After an inauspicious start (Google Health, we hardly knew ye), the search engine giant is approaching healthcare with a vengeance.
* As of October 2013, Google will sign HIPAA business associate agreements for Gmail, Calendar, Drive and the Google Apps Vault. As of last week, BAAs cover Google Cloud, too.
* The Helpouts service connecting laymen to experts anywhere in the world is also HIPAA compliant, making it a compelling option for patient-physician video consultations.
* Though shrouded in secrecy, Google's new medical company, Calico, aims to examine the effects of aging and illness.
* Finally, there's Glass, which in due time will improve documentation, clinical decision support and training.

HP: Improving Patient Workflow
Count HP among the IT vendors with myriad healthcare offerings. Its unifying theme: improving patient workflow from admissions through discharge. Yes, this strategy focuses primarily on printers, though HP's come with access controls (so only the correct people print patient records), can digitize faxes and other paper records and print digital patient wristbands. From there, HP sees clinicians using tablets at the point of care, with records stored in the private cloud, and printing personalized records when patients are discharged.
Meanwhile, HP is pointing its Vertica analytics platform at healthcare, partnering with EHR giant Cerner to analyze some 10 billion data points, ranging from memory usage and system speeds, to help Cerner customers work faster.

IBM: Enabling Smarter Healthcare
IBM's Watson supercomputer can be used in many verticals, but healthcare arguably gets the most attention. So much medical data, from patient history to physician notes to medical journals, remains unstructured, making it difficult for machines to interpret it. Watson's capabilities, recently dubbed cognitive computing, can parse data, combine it with treatment guidelines and the latest medical studies, to suggest and score potential diagnoses — or even, some hypothesize, to cure cancer.
In addition, IBM's Smarter Healthcare initiative (part of its Smarter Cities project, itself part of the Smarter Planet) seeks ways to incorporate that insight into collaborative, patient-centered care processes as a means of emphasizing wellness and prevention, not sickness.

Intel: Better, More Coordinated Care
Intel chips power numerous types of healthcare technology: tablets and other clients used at the point of care, imaging systems and other medical devices, and the architecture that makes life science and healthcare data analytics possible. (That encrypted, high-performance architecture also works well for EHR systems, Intel says.) Taken together, Intel positions this technology as a way to help care teams share information both during and after a patient's hospital stay. That's critical to the success of healthcare reform (and, by extension, the accountable care organization), which rewards groups that assume the shared risk of coordinated care (and, it's hoped, the shared savings) while penalizing high hospital readmission rates and other documented inefficiencies in care.

Microsoft: Improved Access to, Visibility of Information
Microsoft dips its toes into several healthcare pools. Pull back, though, and a definitive focus emerges. There's HealthVault, which ranks among the more recognizable personal health record (PHR) services. There's the HIPAA-compliant Office 365 for Health Organizations, which uses the Direct Project standard for health information exchange. And there's a host of collaboration, business intelligence, relationship management and infrastructure configuration systems from Microsoft Health. Together, these point to a strategy aimed at streamlining healthcare's data-sharing inefficiencies — which unnecessarily complicate, lengthen and add expense to the care process. As healthcare in the United States gravitates toward a model of shared savings (and risk), organizations have little choice but to cooperate.

Oracle: Analytics for Life Sciences
The Oracle list of healthcare tools is a long one — but the focus, given the firm's strengths and acquisition history, isn't terribly surprising. There are some specialized healthcare options, though, particularly for health information exchange, health insurance exchange and clinical data analytics.
Beyond software, the Oracle Health Sciences Network aims to improve the collaboration necessary for effective clinical trials, both by providing access to de-identified patient data from EHR systems and by pulling data from disparate sources such as medical devices or crowdsourcing services such as the Genetic Alliance, which collects data on conditions too rare for clinical trials in the first place.

Samsung: Health Management on Your Phone
Samsung built the S Health app into the Galaxy S III (in the United Kingdom) and the S4 (in the United States). S Health includes a pedometer and food tracker — standard for fitness and wellness apps, but this is built right into the phone. Last month S Health received FDA clearance, meaning it can potentially link via Bluetooth to compatible scales, glucometers and blood pressure monitors. (S Health received similar approvals in 2012 in the U.K., where connections with such medical devices already exist.) U.S. insurer Cigna and Samsung are jointly developing wellness apps that will be built into S Health, which itself may be driving changes to Samsung's UI design in the Galaxy S5.

SAP: Real-Time Analytics
Healthcare data analytics suffers two maladies: Most data is unstructured and most institutions can't analyze data fast enough. Enter SAP HANA, the analytics tool first used in retail and finance. HANA began as a database but has evolved into an in-memory analytics platform; its capability to process transactions as they are captured, and to process them in main memory, simplifies the process fivefold while eliminating the need for redundant storage, SAP says. HANA can also interface directly with mobile devices, untethering physicians from workstations on wheels. With information coming from wearable tech, claims data, past doctor's visits, clinical research and (soon) individual patient genomes, SAP says it's time to rethink healthcare's approach to data.

Siemens: Capturing, Storing and Sharing Medical Images
Like GE, Siemens Healthcare is best-known for its imaging and diagnostic equipment — with particular emphasis on cardiology, oncology, ultrasound, mammography and angiography, among others — and the accompanying syngo imaging software, which serves as both picture archiving and communication system (PACS) and workflow management system so information can be shared among hospital specialties. Siemens Healthcare offerings also include laboratory workflow and process management systems, remote monitoring tools for diagnostic equipment and a variety of acute care, post-acute care and care management systems.

Twitter: Informing Public Health (Intentionally or Otherwise)
Twitter itself isn't developing products for healthcare, but its mere existence makes an impact. Traditional public health reporting takes months, given the number of agencies involved, but services such as HealthMap — which monitors Twitter and 50,000 other sites in 15 languages to generate as many as 2,000 alerts a day — can extract free text from those sites and conduct "digital disease detection" in weeks, if not days, says Dr. John Brownstein, a pediatrics professor at Harvard Medical School and Children's Hospital (Boston). Such analysis is 91 percent accurate, he says, and helped uncover bird flu in China, swine flu in Mexico and polio in Syria, not to mention foodborne illnesses in the United States months before the CDC knew.

Verizon: Securely Connecting Systems and Devices
Verizon's healthcare offerings, not surprisingly, focus on secure networking, machine-to-machine connections and mobility. The company is clearly capitalizing on the growing need for healthcare organizations to share data without falling into the wrong hands — a topic Verizon approaches annually in its (often sobering) data breach investigation report. Most recently, Verizon launched a HIPAA-compliant, FDA-approved cloud platform that lets patients aggregate data from their remote monitoring devices for viewing in a Web portal or smartphone and for further clinical analysis. This hits two other healthcare trends: improving patient engagement (by helping patients share data with physicians' offices) and the patient-centered medical home (by reducing the need for otherwise routine office visits).

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